international conference on spice prevention issues 2004, a ‘herbal incense’ product sold under

International Conference on SPICE Prevention Issues

Conference Handout

First International Conference on Toxicity, Risk Profiles, Legal Control and Prevalence of Synthetic Cannabinoids

25-26 September 2012, Frankfurt am Main

Conference Handout Conference on SPICE Prevention Issues 2012 3

Introduction

Welcome to the Conference on SPICE Prevention Issues 2012. We are delighted to share the results

of the research on toxicity and prevalence of synthetic cannabinoids collected in the context of the

EU-project SPICE and synthetic cannabinoids, which is funded by the European Commission, the

Federal Ministry of Health and the City of Frankfurt. The conference gives the opportunity to learn

more about the phenomenon of Spice Products and to discuss prevention approaches applicable to

new psychoactive substances.

Around 2004, a herbal incense product sold under the brand name Spice appeared in Europe.

Herbal incense or herbal smoking mixtures were gaining a high degree of popularity by mid-2008. In

December 2008, German labs identified synthetic cannabinoids in these products. Synthetic

cannabinoids (or, more precisely, cannabinomimetics) are psychoactive substances that mimic the

effects of 9-tetrahydrocannabinol (THC), the main active compound in cannabis / marijuana. They

bind to the same cannabinoid receptors in the brain as THC. However, many of the synthetic

cannabinoids are much more potent than THC.

Usually the synthetic cannabinoids are sprayed on the plant material. The herbal mixtures are sold in

small bags with a brand name on it, often labelled not for human consumption. The active

compounds are not declared as ingredients on the packaging. Since Spice products are mostly sold

and discussed on the Internet, they are often regarded as largely an Internet phenomenon

(EMCDDA 2009) and therefore (m)onitoring the Internet is becoming essential to identify and

understanding new trends (Deluca 2012).

Most of the respective cannabinoids were first synthesised in the context of pharmaceutical research

projects carried out in the 80s and 90s. They had never shown up in any commercially available

product before and no human studies with these cannabinoids have been carried out (EMCDDA

2009). The JWH series, created by the chemist John W. Huffmann at Clemson University, is the most

common family of synthetic cannabinoids (e.g., JWH-018, JWH-073, and JWH-210). Other names of

cannabinomimetics include HU-210, AM-694 or CP 47,497. There are hundreds of synthetic

cannabinoids that may function as active compounds of herbal mixtures (Rosenbaum et al. 2012).

The constant change substances used by manufacturers and traders makes it difficult to assess,

monitor and control the supply of these products. Furthermore, prevention and treatment agencies

face new problems associated with the use of herbal mixtures and other legal high products (see,

e.g., NACD 2011).

There is a strong need of organisations active in prevention work for scientific facts and arguments

when discussing the risks associated with the use of new psychoactive substances with drug users.

For health care providers it is important to be familiar with symptoms of intoxication and other side-

effects. Therefore it is necessary to supply substantial science-based information on toxicity and risk

profiles.

So far, there have been few reports on clinical effects in humans of herbal mixtures or synthetic

cannabinoids (Forrester et al. 2012). The knowledge on the toxicity of these substances is limited, but

indeed there are some reasons for concerns that these drugs may have a greater potential to cause

harm (EMCDDA 2009). These assumptions largely derive from the fact that many

cannabinomimetics work as full agonists to the human cannabinoid receptors, while THC shows only

partial agonist affinity. There are speculations that some synthetic cannabinoids may have a

carcinogenic potential. Furthermore, some of these substances might have a relatively high potential

to cause dependence and intoxications because of the unknown ingredients as well as the varying

amounts and potencies of added drugs.

Conference Handout Conference on SPICE Prevention Issues 2012 4

International Conference on SPICE prevention issues

Programme

Tuesday 25 September

12:30 Registration

Chair: Albert Kern, Federal Ministry of Health, Germany

13:15 Welcome and opening remarks

PD Dr. Volker Auwrter (University Medical Center Freiburg)

Ms. Judith Bugreev (Office of the Drug Commissioner of the Federal Government)

Ms. Rosemarie Heilig (Councillor for Environment and Health, City of Frankfurt)

Michael Evans-Brown (EMCDDA)

Presentation of the results of the SPICE project

Plenary session

14:00 PD Dr. Volker Auwrter, University Medical Center Freiburg

Analytical and clinical experiences - from product monitoring to drug testing

14:15 Prof. Dr. Siegfried Knasmller, Medical University Vienna

Assessment of toxicological properties and establishment of risk profiles

Dr. Verena Koller, Medical University Vienna

Genotoxic properties of selected spice compounds

14:30 Prof. Dr. Ilkka Ojanper, University of Helsinki

Detection of synthetic cannabinoids in human specimens

Teemu Gunnar, National Institute for Health and Welfare, Helsinki

Prevalence of SPICE products in Finland

14:45 Prof. Dr. Bela Szabo, Albert-Ludwigs-University Freiburg

Effects of synthetic cannabinoids, identified in smoking herbal products, on synaptic transmission

in the brain

15:00 Dr. Werner Bernhard /Prof. Dr. Wolfgang Weinmann, University of Bern

Measures in Switzerland in the fight against new drugs such as SPICE products and bath salts

15:15 Discussion

15:30-16:00 Break

16:00 Michael Ptz, Federal Criminal Police Office, Germany

Legal Highs in the legal system

16:15 Dr. Bernd Werse, Centre for Drug Research, University of Frankfurt

Social research on synthetic cannabinoids: A synopsis of the available data

16:30 Michal Kidawa, National Bureau for Drug Prevention, Poland

Legal Highs in Poland

16:45 Discussion

17:00 Concluding remarks

Conference Handout Conference on SPICE Prevention Issues 2012 5

International Conference on SPICE prevention issues

Programme

Wednesday 26 September

Chair: Albert Kern, Federal Ministry of Health, Germany

Legal Highs: New challenge for traditional prevention approaches?!

Plenary session

9:15 Stefanie Helmer, Institute for Epidemiology and Prevention Research GmbH (BIPS), Bremen

Findings of a German subsample of a European social norms intervention study.

9:30 Renate Lind-Krmer, Drug Coordination Department of the City of Frankfurt am Main /

Karsten Tgel-Lins , basis e.V.

Keynote speech on prevention advice

10:00 Alexander Bcheli, City of Zurich, Departement of Social Affairs, Addiction and Drugs,

Streetwork Youth Advisory Service

Keynote speech on prevention advice

10:15-10:30 Break

Panel discussion

10:30 Renate Lind-Krmer, Drug Coordination Department, City of Frankfurt, Germany

Alexander Bcheli, City of Zurich, Departement of Social Affairs, Addiction and Drugs,

Streetwork Youth Advisory Service

John Arthur, Crew 2000, Edinburgh, UK

Mireia Ventura, Energy Control, Spain

Michaela Goecke, Bundeszentrale fr gesundheitliche Aufklrung (Federal Centre for Health

Education), Germany

12:00 Concluding remarks

http://www.uniklinik-freiburg.de/rechtsmedizin/live/SpiceConference.html

Conference Handout Conference on SPICE Prevention Issues 2012 6

Analytical and clinical experiences from product monitoring to drug testing

V. Auwrter, M. Hutter, S. Kneisel

Institute of Forensic Medicine, Forensic Toxicology, University Medical Center Freiburg, Germany

Products containing synthetic cannabinoids have become a challenge for many professions, among

them medical staff and chemists, but also staff working in the area of drugs prevention or drugs

counselling.

In the frame of the SPICE project we conducted a continuous product monitoring providing

information on the substances used as active ingredients for these products. Since 2008 more than

40 different compounds appeared in herbal mixtures and the product composition was constantly

changing in terms of type and amount of added drugs. In Germany we observed a quick reaction of

the producers to legislative measures in the first years. Interestingly, the shift to new substances was

observed even before new regulations came into force. Further observations were a trend to the use

of high affinity cannabinoid receptor agonists and the appearance of rather exotic modifications,

many of them not described in the scientific literature before. Recently, producers seem to partially

revert to already legally controlled substances like JWH-018.

The continuous monitoring of the Spice product market enabled us to develop up-to-date methods

for the detection of synthetic cannabinoids in blood, urine, oral fluid and hair. These methods help to

mitigate one of the major motivations for the use of these drugs the lacking detectability by

commonly used drug test systems. However, these meth